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National Advocacy Conference

National Advocacy Conference

View highlights from the 2013 National Advocacy Conference

Sebelius: Health care is changing, AMA is leading the way

HHS Secretary Kathleen Sebelius Medicare's SGR formula must be eliminated if the health care system is to continue to evolve, HHS Secretary Kathleen Sebelius said in Tuesday's address.

As President Obama puts the final touches on his State of the Union address, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius gave a report Tuesday on the state of health care in the United States during a speech to hundreds of the nation’s physicians at the AMA’s National Advocacy Conference.

“Today I can report that the state of American health care is getting stronger—thanks in large part to America’s doctors,” Sebelius said.

Pointing to dozens of new payment and delivery models that are taking shape across the country, Sebelius noted that physician leadership will continue to be key to improving the health care system for physicians and patients alike.

“Thoughtful planning is best,” she said. “That’s why I’m so grateful to the AMA for leading the way on care improvement.”

Sebelius said she knows there’s a lot still to learn about these new models of care, and HHS is looking to physicians to guide national initiatives.

“If your organization is already participating in a new care model,” she said, “let us know how we can support your efforts. And help educate us about what’s working and what isn’t so we can build those insights into our policies. If you’ve been waiting to get involved in a new model, now is the time to take the leap.”

She noted that the health care system is evolving based on the needs of a changing patient population and that there are opportunities for health care groups of all shapes and sizes to better meet those needs.

In addition, Sebelius emphasized that the Medicare sustainable growth rate (SGR) formula must be eliminated if the health care system is to continue to evolve—a position the AMA continues to underscore.

“We remain committed to an SGR fix that will take America’s doctors out of a permanent state of limbo,” she said. “[T]emporary extensions are not good enough. We need to bring an end to constant uncertainty for doctors and patients.”

She also noted that repealing the SGR is only the first step. She encouraged physicians to continue to be strong leaders in ushering in changes that will benefit patients, physicians and the nation.

As part of its strategic focus, the AMA is working to shape delivery and payment models in an effort to cultivate sustainable physician practices that result in good health outcomes for patients and greater professional satisfaction for physicians. Learn more about this initiative.

Physicians take medicine's concerns to nation's capital

Stephen Imbeau, MD, and Gary Woods, MD Stephen Imbeau, MD, of Florence, S.C. (left), and Gary Woods, MD, of Concord, N.H., chat Monday between sessions.

Hundreds of physicians from across the country have gathered in Washington, D.C., to discuss key issues in health care, hear from policy experts and voice their concerns to their members of Congress during the AMA’s National Advocacy Conference (NAC).

As the new Congress gets under way and President Obama’s second term begins, physicians are making sure their lawmakers understand the importance of medicine’s most pressing matters.

Topping the list are the impending federal budget sequester cuts. If Congress doesn’t act by March 1, the sequester will trigger 2 percent cuts to Medicare physician payments and Medicare financing for graduate medical education. The cuts would take effect April 1 and last for nearly a decade.

Other high-priority issues include repealing the failed Medicare sustainable growth rate, or SGR, formula, providing a transition to new Medicare payment and delivery models, and addressing the national prescription drug abuse crisis.

Robert Hughes, MD, of the Medical Society of the State of New York, said the NAC is an important event for physicians to attend so they can communicate with their legislators about the vital issues in medicine.

“It’s important for us to be here because … we really represent the patient and the doctor-patient relationship,” he said. “No one else does that.”

Thomas Whiteman, MD, chairman of the Indiana State Medical Association board of trustees, said the NAC is an important opportunity for physicians to “interact with colleagues from all over the country who are dealing with many different issues. The NAC gives you an unlimited opportunity to learn from other perspectives.”

NAC attendees have said participating in the conference is a particularly special way to engage in grassroots advocacy.

Simply being in the nation’s capital is inspiring, said Gordon Hughes, MD, president of the Indiana State Medical Association.

“When you fly in and see the national monuments, you get refocused on the big picture,” he said. “There’s just something about being here.”

Compromise necessary to address nation's budget crisis

NBC's Chuck Todd The gridlock on Capitol Hill is a result of lawmakers on both sides of the aisle viewing "compromise as a capitulation," NBC's Chuck Todd told attendees.

While political gridlock and budget woes have defined American politics in recent years, does the immediate future hold any promise for change? Chuck Todd, NBC News’ political director and chief White House correspondent, offered insight into what the next six months might look like during a featured address Monday.

Chief among Todd’s analysis was the approaching federal budget sequester. Scheduled to take effect March 1, the sequester will slash federal funding for defense and domestic programs, harming the economy and eliminating jobs, Todd said.

“The inability of Congress to pass a real budget has real-world consequences,” Todd said, noting the negative impact the sequester’s 2 percent cut to Medicare payments would have on physicians’ practices.

While Congress needs to act in the next few weeks to stave off these cuts, Todd speculated that the partisan nature of politics in the nation’s capital likely will prevent lawmakers from reaching a solution.

Politicians on both sides of the aisle are avoiding compromise, Todd said.

“They see compromise as a capitulation, not a victory for both sides,” he said. “If you want to get stuff done, then there has to be a voting incentive” to compromise.

Todd does see some hope for resolution of the budget crisis, however. As with the general public, there is exhaustion over the nation’s debt-ceiling issue among Congress, Todd said. The president likewise wants to move on to other priority issues, and Republicans are interested in spending more time repairing the party and preparing for the next presidential race, he said.

What remains uncertain is how long it will take Congress and the White House to resolve the budget problem and what that solution will look like.

AMA leaders highlight pressing topics in medicine

Ardis D. Hoven, MD AMA President-elect Ardis D. Hoven, MD, answers a question from the audience during Monday's AMA leadership panel discussion.

As the AMA National Advocacy Conference kicked off Monday, physician leaders discussed some of the biggest issues facing the profession today. AMA President Jeremy A. Lazarus, MD, AMA President-elect Ardis D. Hoven, MD, and AMA Board of Trustees Chair Steven J. Stack, MD, shared their perspectives on issues ranging from public health to practice technology. Among the topics discussed were preventing gun violence, supporting sustainable practices for all physicians, addressing prescription drug abuse and helping relieve physicians’ regulatory burdens.


Medical students advocate for future of medicine

AMA Medical Student Advocacy Day Medical students from the Florida medical schools meet Monday with an aide to Sen. Bill Nelson, D-Fla.

More than 300 medical students from 29 states headed to Capitol Hill on Monday as part of the AMA’s Medical Student Advocacy Day to talk with their members of Congress about what needs to be done to protect the future of health care in the United States.

The students held 144 meetings with members of Congress and key staffers. The most pressing of the students’ concerns was preserving graduate medical education funding, which is slated for a 2 percent cut under the federal budget sequester. The number of residency slots also has not kept pace with the increase of U.S. medical students or the demand for care, thanks to a cap that was first set in 1997.

“It’s an important issue for the country because we need more doctors,” said Mark Kashtan, a second-year medical student at the Medical College of Wisconsin. “For us [medical students], it’s the rest of our lives. Since we’re the closest people to it, we need to be the most vocal advocates for it.”

Before discussing this and other issues on Capitol Hill, students received a day of training Sunday, including lobbying practice and tips from experts.

“Advocacy Day teaches medical students how to advocate effectively,” said Shannon Brockman, a second-year medical student at the University of Florida College of Medicine. “Students receive instruction on how to talk to congressional aides and on other parts of the lobbying process.”

Since first participating in the event last year, Brockman has been able to build a relationship with her congressman’s office. She hopes the staff will rely on her and other students in the future to better understand some of the critical issues in medicine.

AMA Medical Student Advocacy Day This year's AMA Medical Student Advocacy Day drew more than 300 medical students from 29 states.

With so many medical students participating in Advocacy Day each year, their efforts leave a lasting impression on Capitol Hill.

“[The event] shows politicians that we care about the future of health care and that we’re willing to fight to ensure that it’s maintained for the betterment of patients,” said Jade Anderson, a second-year medical student at Boston University School of Medicine.

Advocacy Day participants say there are other welcome benefits of the event as well.

“I think most importantly it teaches us about the issues that we should continue to follow, support and share with our classmates,” said Elizabeth Sibrack, a second-year medical student at the East Carolina University Brody School of Medicine.

Ryan Ribiera, a fourth-year medical student at the University of California Davis School of Medicine, appreciates the social aspect of the event. “Advocacy Day lets you become friends with students from around the country,” he said. “It’s another reason I keep coming back after four years.”

Congressmen to physicians: We need your input

Rep. Fred Upton, R-Mich. Rep. Fred Upton, R-Mich., shared details Wednesday of a proposal to eliminate Medicare's SGR formula.

Two members of Congress told physicians Wednesday morning that lawmakers need to hear from physicians on important health care topics.

Rep. Fred Upton, R-Mich., who chairs the U.S. House Energy and Commerce Committee, announced that the committee is on track to submit a plan to fix the broken Medicare payment system before Congress’ summer recess.

"Our goal is to get it done this year, to actually have it on the House floor before the end of the summer—July or the first week of August," Upton said.

The proposal would eliminate the sustainable growth rate formula and transition over a period of time to fees based on quality and clinical improvement. Upton said such measures “must come from the medical profession” and should be flexible for all specialties.

“It’s essential that we have input from you,” Upton said. “That is the only way it will work.”

The AMA and 100 other medical associations have given Congress core principles and elements for a new, high-performing Medicare system that uses an array of delivery and payment models that help lower costs and improve quality.


Sen. Sherrod Brown, D-Ohio, said it is by speaking out that physicians really make a difference for public health. He encouraged physicians to meet with their lawmakers, whether at home or in Washington, D.C., and tell them how they can better help patients.

Sen. Sherrod Brown, D-Ohio Sen. Sherrod Brown, D-Ohio, encouraged physicians to educate their lawmakers about pressing health care issues.

“What I’ve been able to do in health care is because physicians have come to me and explained things,” he said.

Brown noted that members of Congress need to be educated about such pressing health care issues as graduate medical education and mental health.

“What you do as individual doctors is so important,” he said, “and what you do as a group—as an organization—is equally as important.”


Combating prescription drug abuse: A long way to go, but making progress

Gil Kerlikowske Gil Kerlikowske applauded physicians' efforts in helping to address the nation's prescription drug abuse epidemic.

While prescription drug abuse continues to plague the country, a number of national initiatives are beginning to make an impact, said Gil Kerlikowske, director of the U.S. Office of National Drug Control Policy, during a Wednesday session.

In 2011 Kerlikowske’s office released the Prescription Drug Abuse Prevention Plan, leading nationwide initiatives to reduce abuse of medications. Prescription drugs are the second most abused category of drugs after marijuana, and more people die each year from prescription drug abuse than gunshot wounds, Kerlikowske said.

Kerlikowske noted that the public debate on this issue is highly polarized, with people either holding to the decades-old “war on drugs” or claiming that legalization of illegal drugs will help solve the problem.

“But right in the middle are solutions that work,” Kerlikowske said.

He pointed to such public health efforts as education programs, especially for young people who often believe that drugs coming from prescription bottles are somehow safe, and treatment programs for those struggling with addiction.

“We’ve already made a huge difference in this,” he said, “and it’s because of your knowledge and support.”

Another initiative that has proven effective is state prescription drug monitoring programs, he said. These databases are intended to empower physicians to identify potential abusers while still helping patients who need pain management. Kerlikowske said that his office is trying to make these databases interoperable and available across state lines.

The AMA is doing its part as well, offering on-demand webinars covering safe opioid prescribing and the epidemiology of overdoses.

Kerlikowske applauded physicians’ efforts in helping to address the prescription drug abuse epidemic and thanked them for their continued input on the Office of National Drug Control Policy’s work.

“We stand by to support you on this issue,” he said. “We value and appreciate the relationship, dialogue and conversation. Our door is always open to you.”

U.S. economy needs balanced national budget, former comptroller general says

Former comptroller general David Walker "Math is the new four-letter word in Washington," former comptroller general David Walker said Wednesday.

If the U.S. economy is to survive, the government needs to change course, and do it soon. That’s the message David Walker, a former comptroller general of the United States, delivered Wednesday during the AMA’s National Advocacy Conference.

The federal government has had a $1 trillion deficit for four years in a row, Walker said. The national debt now stands at $16.5 trillion, up from $5.6 trillion in 2000.

When the statutory budget control expired in the mid-1990s, Congress dramatically increased spending, Walker said.

“They burned a whole in their pocket, through the floor and almost all the way through the planet,” he said.

As the March 1 federal budget sequester approaches, it is becoming more evident that things must change.

“Math is the new four-letter word in Washington,” Walker said. But dramatic reforms will be necessary to get the country back on course for a healthy economy.

Not focusing on costs “ignores reality,” he said. “We do not have a blank check. We have to allocate resources.”

Walker noted that changes will have to be made in health care as well. Next to interest on the national debt, health care is the fastest growing expense in the country.

Walker suggested that an option for the future is centering the health care system more on evidence-based medicine. Payments would be made for evidence-based practices, not volume of services, and safe harbors protecting physicians from unnecessary lawsuits could be created as a result of those practices.

Across all areas of spending, Walker said, the country must do “what is appropriate, what is affordable and what is sustainable.”